Cleveland is an urban community with several Health Care systems, internationally renowned researchers and a rich history of cooperation with respect to Stroke Care. University Hospitals of Cleveland (UHCMC), The Cleveland Clinic (CC), Metro Health Medical Center (MHMC) and Louis Stokes Cleveland Department of VA Medical Center (LSCDVAMC) are affiliated with Case Western Reserve University (CWRU) and collaborate in a Clinical Translational Science Collaborative (CTSC- funded by a CTSA) to enhance training, research, and discovery in Cleveland. We propose to work within the framework of the CTSC to develop the Cleveland NINDS Stroke Trials Collaborative and serve as a Regional Coordinating Center for the NINDS Stroke Trials network. This proposal will capitalize on the many strengths within our community. With multiple experienced sites within our Collaborative, we will be able to enroll large numbers of patients into a wide variety of trial. Furthermore, we have a diverse research community in Cleveland, including clinical researchers, basic scientists, engineers and biotech companies, with whom we can collaborate to bring new projects to the network. We propose a multi-tiered leadership. Dr Anthony Furlan and Dr. Peter Rasmussen will lead the Collaborative as PIs, and representatives from each of the four hospitals will sit on the Executive committee with the PIs, as will a Project Manager. The Executive Committee includes both senior and mid- level investigators and will serve to oversee and run all major aspects of the Collaborative, but also provide close mentorship for the mid-level investigators, with the intent that they will progressively assume leadership responsibilities. In addition, we have assembled a multidisciplinary cadre of investigators from all four hospitals willing to serve as site-PIs and co-investigators. There will be regular communication between sites and between the Executive Committee and the Collaborative as a whole. With the expertise and resources detailed in this application, the Cleveland Stroke Trials Collaborative enhance the structure and organization be well positioned to accelerate participation in clinical trials for stroke acute intervention, prevention and rehabilitation in boh adults and children.